Health and Humanitarian Logistics. Richard J. Brennan, Director, Emergency Operations

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1 Health and Humanitarian Logistics Richard J. Brennan, Director, Emergency Operations

2 Unprecedented Scale of Risks and Needs 135 million people in need >65.3 million displaced >80% due to conflict >200 epidemics/year, e.g. SARS, H1N1, MERS, Ebola, Zika 200 million+ affected by natural & techno disasters/ year

3 Global Landscape 8 7 No. Grade 3 Emergencies countries

4 Epidemic events globally, NUMBER OF COUNTRIES Cholera Menengitis Shingellosis Chikungunya Zika fever West Nile fever Typhoid Yellow fever MERS-CoV Plague Influenza A Crieman Congo HF Ebola Lassa fever Rift Valley Fever Monkeypox Nipah Marburg Noding More than 1000 epidemic events in 168 countries

5 The scale of the challenge WHO is responding to 50 acute and protracted emergencies

6 ..and it's not getting any better Drivers of risk increasing Climate change Emerging diseases State fragility 38 countries alert to very high alert Migration Demographic shifts Urbanization Terrorism Protracted nature of conflict Average period of displacement 7 yrs DR Congo = 21 yrs Somalia = 26 yrs

7 Important Considerations Convergence of health security and humanitarian agendas Emergencies outbreaks Outbreaks emergencies Threats to SDGs 8 of 10 countries with highest U5MR = emergency 9 of 10 countries with highest MMR = emergency

8 19 June 2017 Logistics in Humanitarian Health Action Logistics and operational support Critical function in all phases of humanitarian health action Effectiveness directly impacts PH outcomes Logistics requirements vary by operational context

9 19 June 2017 Logistics in Humanitarian Health Action Complex settings, e.g. political, social, economic Broad range of health needs Supply chain and field support vital to maintaining operations Other services IT, communications, security, fleet management, etc

10 Logistics in Humanitarian Health Action Guiding principles Building on local capacities and systems Partnership Leveraging comparative advantages, e.g. UNICEF on vaccinations; WFP WHO joint operation in Ebola Intersectoral collaboration, e.g. WASH, nutrition, food aid Evidence- and knowledge-based Adhere to tech standards, track KPIs Link LMIS to HMIS Public Health Information Standards 19 June 2017

11 Operational Support & Logistics Tactics Proactive, Timely and Adaptable Effective OSL provides the people, material resources, financial resources, systems and processes to support effective field response Policies Emergency OSL Skilled Human Resources Operations Supply Chain Management - Needs Forecasting - Procurement of medical and non-medical supplies - Warehousing - Goods transport & distribution - Coordination of Stakeholders Technical Health Logistics - Medical utilities support - IPC and Safe Burial - Medical utilities water & sanitation - Mobile medical team support - Laboratory support & sample management - Biomedical support Operations Support - Office Support - Team Living Support - Team transport & Security - Fleet Management - Communications Network - Energy Requirements - Daily Cash Management

12 Humanitarian Logistics in Outbreaks Preventing acute PH events from becoming PH Emergencies PH event Early detection & response Amplification

13 19 June 2017 Centrality of Supply Chain Risk Assessment Selection Forecasting and budgeting Procurement Delivery and clearance Warehousing and distribution Utilization

14 19 June 2017 Humanitarian Logistics in Outbreaks Specific considerations Surveillance, including sample transport, mobile laboratories, contact tracing teams Infrastructure support to health facilities, e.g. waste management Infection Prevention and Control, including isolation unit set up Timely access to affordable vaccines, e.g. ICG, Humanitarian Mechanism Cold chain support to last mile Safe and dignified burials; associated training Reliable telecom infrastructure

15 19 June 2017 Humanitarian Logistics in Outbreaks Challenges Unwillingness of governments to declare Weak health systems Lack of emphasis on country preparedness Transport of patients and specimens Medical evacuation of staff

16 Humanitarian Logistics in Outbreaks: Pandemic Preparedness No single agency with all relevant capacities Leverage resources of all relevant partners, e.g. governments, private sector, operational agencies Virtual Global Supply Chain 19 June 2017 Scenario planning, modelling and stockpiling, e.g. UNICEF s HEPI

17 Humanitarian Logistics in Outbreaks: Coordination 19 June 2017 Most instances: GOARN, Health Cluster Large-scale outbreaks: Learning lessons from Ebola IASC Level 3 Activation Procedures for Infectious Disease Events Activation of logistics cluster, deployment of supplies for 3 months

18 Humanitarian Logistics in Conflict & Protracted Emergencies Specific considerations Complexities multiple hazards Negotiations with warring parties re access Diversion and removal of supplies and equipment Specific medical requirements Management of trauma Management of NCDs Humanitarian pauses 19 June 2017

19 Humanitarian Logistics in Conflict and Protracted Emergencies Challenges Poor access, lack of humanitarian space Disrupted or poorly developed supply chains Remote management and monitoring Lack of local capacity dependence on international community Bureaucratic constraints Attacks on health care Risk management Lack of funding 19 June 2017

20 19 June 2017 Humanitarian Logistics in SODs Specific considerations Need for speed, scale, effectiveness Need for local and regional capacities EMTs Standards Self sufficient Verification process Sovereignty Tasking of teams

21 19 June 2017 Humanitarian Logistics in SODs Challenges Disruption of infrastructure Damage to health facilities Coordination of large number of responders Inappropriate donations

22 Building Global Capacities for Humanitarian Health Action National capacities IHR JEE and Country Action Plans Capacity building activities 19 June 2017 Global Health Emergency Workforce/Capacities National capacities Regional networks GOARN, GHC, EMTs

23 Building Global Capacities for Humanitarian Health Action 19 June 2017 Supply chain and stockpile initiatives International Coordination Group UNICEF HEPI, WHO emergency stocks, FAO, WFP, others Global Pandemic Supply Chain Initiative Public Sector Round Table

24 Building Global Capacities for Humanitarian Health Action Financing CERF Pandemic Financing Facility Agency-specific funds, e.g. WHO CFE Political engagement G20 simulations Promoting interoperability IASC Level 3 protocols 19 June 2017

25 19 June 2017 Conclusion Complexities of logistics and ops support in humanitarian emergencies Operational requirements vary by context Comprehensive approach All phases of emergency management cycle Supply chain Health Logs Field support Partnership and coordination vital Concerted efforts to build capacities at national, regional and global levels